Suicide risk in depression and bipolar disorder: Do impulsiveness-aggressiveness and pharmacotherapy predict suicidal intent?

Maurizio Pompili^1,2, Marco Innamorati³, Michele Raja⁴, Ilaria Falcone², Giuseppe Ducci⁵, Gloria Angeletti², David Lester⁶, Paolo Girardi², Roberto Tatarelli², Eleonora De Pisa²

¹McLean Hospital, Harvard Medical School, Boston, MA, USA; ²Department of Psychiatry, Sant’Andrea Hospital, “Sapienza” University of Rome, Italy; ³Università Europea di Roma, Italy; ⁴Diagnostic and Therapeutic Psychiatric Services, Department of Mental Health, Santo Spirito Hospital, Rome, Italy; ⁵Diagnostic and Therapeutic Psychiatric Services, Department of Mental Health, San Filippo Neri Hospital, Rome, Italy; ⁶Center for the Study of Suicide, Blackwood, NJ, USA

Abstract: The aims of the present study were to examine clinical, personality, and sociodemographic predictors of suicide risk in a sample of inpatients affected by major affective disorders. The participants were 74 inpatients affected by major depressive disorder or bipolar disorder-I. Patients completed a semi-structured interview, the Beck Hopelessness Scale, the Aggression Questionnaire, the Barratt Impulsiveness Scale, and the Hamilton scales for depression and anxiety. Over 52% of the patients were high suicide risks. Those at risk reported more severe depressive-anxious symptomatology, more impulsivity and more hostility. Impulsivity, the use of antidepressants, anxiety/somatization, and the use of mood stabilizers (a negative predictor) resulted in accurate predicting of suicide intent. Impulsivity and antidepressant use were the strongest predictors even after controlling for several sociodemographic and clinical variables.

Keywords: suicide, mood disorders, pharmacotherapy, impulsiveness, aggressiveness